| NPI | 1376145623 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 72223) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL ME.44782) | 
| Enumeration Date | 2020-11-11 | 
| Last Update Date | 2024-06-19 |